My Lab Results

Here are my lab results time after time. What do you think of these?

05/19/1990
HBsAg positive, abs: 1.085/cf: 0.092
HBsAb negative, abs: 1.516/cf: 0.390

06/06/1990
AST 119
ALT 87
IGM Anti HBc negative, abs: 0.034/cf: 0.247
Albumin 3.7
Globulin 3.1
Gamma globulin 1.65
Total protein 6.8
Direct bilirubin 0.22
Total bilirubin 0.43

06/23/1990
AST 19
ALT 13
Direct bilirubin 0.17
Total bilirubin 0.32.

04/30/1993
AST 23
ALT 19
HBsAg positive abs: >2/cf: 0.1801
HBsAb negative abs: 0.200/cf 0.254
Anti HBc positive abs: 0.093/cf: 0.330

04/09/1994
AST 22
ALT 18
HBsAg positive abs: >2/cf: 0.370
HBsAb negative abs: 0.076; cf: 0.197
Anti HBc positive abs 0.265/cf: 0.449
HBeAg negative abs 0.024/cf: 0.085
Direct bilirubin 0.11
Total bilirubin 0.48
Gross titration 1.8
TTT 0.9

05/06/1995
AST 34.9
ALT 27.0
HBsAg positive abs 0.992/cf 0.056
HbsAb negative abs 10.1/cf 30.8
Direct bilirubin 0.17
Total bilirubin 0.45

09/19/2001
AST 12
ALT 16
HBs Ag positive abs: >2/cf: 0.052
Anti HBs negative abs: 0.011/cf 0.067

06/18/2005
AST 26
ALT 25
HBsAg positive
HBsAb negative

Note:
AST = aspartate transaminase = SGOT
ALT = alanine transaminase = SGPT
HBsAg = hepatitis B surface antigen
HBsAb = hepatitis B surface antibody
HBc = hepatitis B core
HbeAg = hepatitis B envelope antigen
IGM = immunoglobulin M

No Hepatitis?

Last week a naturopath named Ir. Donny Hosea MBA PhD N.D. visited this page and dropped an email to me. Since the time we developed an interesting discussion about my disease. I sent my lab’s results to him –oh, I forgot to share them with you… I’ll do it in a few days….

Do you want to know what he said?

Opposed to my mind (and the doctors I've met before), he said that I might have no chronic hepatitis due to no sign of any liver damage nor failure. The lab’s results showing that my HbsAg (hepatitis B surface antigen) was positive while my HbsAb (hepatitis B surface antibody) was negative might be caused by another infection or just malnutrition.

He wrote, “I need to set your mind to just start from the beginning, analyze your problem by indicating all the possibilities of what happened to your body. Human is human. If there are any symptoms appear, then you must check all the possibilities, what made the symptoms. Eliminate the problems, and let the body do the natural way by his/her system to cure the problems.”

His opinion really makes me in two minds. Am I a chronic hepatitis B sufferer? Or not at all? I’ve been sure –and fear– that I suffered from chronic hepatitis B for more than 16 years. But his opinion gives me a glitter of hope. I’m preparing to change my mind, of great hopes it will be true.

But which one is true? Wait, I’m still discussing with him….

Preventive Treatment for Hepatocelullar Carcinoma

Patients who develop hepatocellular carcinoma (HCC), a type of liver cancer caused by the hepatitis B virus, have up to a 55 percent chance of having the virus reactivated during chemotherapy. The idea of preemptively treating these patients with the antiviral drug lamivudine in order to prevent hepatitis B relapse and it varying complications is promising but has never been investigated in patients with HCC.

Researchers led by Jeong Won Jang of the Department of Internal Medicine at the Catholic University of Korea in Seoul, conducted a prospective randomized study on pretreating HCC patients undergoing chemotherapy with lamivudine between January 2004 and February 2005. The study involved 36 patients with HCC who were given the drug while undergoing transarterial chemo-lipiodolization (TACL) chemotherapy and a control group of 37 patients who underwent the chemotherapy without receiving lamivudine.

The chemotherapy was continued every month without any limit on the number of cycles until the tumors disappeared, while treatment with lamivudine began with the chemotherapy and continued for 12 months following its completion.In total, 43 percent of the patients in the control group developed overall clinical hepatitis during the follow-up period, compared to 17 percent of the patients who took lamivudine.

In addition, there was a significantly higher incidence of severe hepatitis in the control group and the researchers established the level of viral load (>104 copies/ml) that predicted whether a patient would have a relapse of hepatitis B.In addition to demonstrating that treatment with lamivudine significantly reduced hepatitis B reactivation, allowing chemotherapy to continue in these cancer patients, the study suggests that lamivudine therapy decreases the severity of clinical hepatitis if it develops during chemotherapy.

"The beneficial effects of preemptive therapy on the severity of hepatitis most probably result from an elimination of any potential risk arising from viral reactivation," the authors state.

While previous studies have shown a higher viral load as a predictor of hepatitis B reactivation, the lower cutoff in the current study was identified as a better predictor and the authors urge the use of a highly sensitive test to detect and measure viral load in order to identify patients at the greatest risk of hepatitis B reactivation.

In those patients with lower viral loads, it would still be beneficial to closely monitor virological and biochemical changes when they are undergoing repeated courses of chemotherapy, since the study demonstrated that even lower viral loads are associated with an approximately 30 percent risk of viral reactivation.

Although the study did not examine long-term survival in the patients who took lamivudine, the authors conclude: "Given that preemptive antiviral therapy ameliorates the hepatic morbidity seen during transarterial chemotherapy and facilitates further chemotherapy without disruptions in the treatment schedules, the expectation would be for an increased chance of survival with this approach."

(From the February 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). http://www.interscience.wiley.com/journal/hepatology.)

Semanggi Vs Chronic Hepatitis

In my town, Surabaya, “semanggi” is a name of traditional food made from boiled Semanggi (Oxalis corniculata L, Cu jiang cao, a kind of wild grass) leaves, served with sauce and cassava crisp. It is usually sold by a woman walks door to door throughout the town.

Yesterday I found an article about its use as herbal remedy. It is said that 600 ml of water boiled with 30-40 grams semanggi leaves on small fire until remains 200 ml, drunk twice a day (100 ml each) can cure chronic hepatitis. It also cures diarrhea, and as gargle cures sprue and other mouth infections.

There are many other uses of Oxalis corniculata. If fresh oxalis herbs are pulverized and dabbed, it can cure wounds, eczema, abscess, scabbies, singe, prickly heat, and insect bites. It is said that drinking the mix of the fresh herbs extract and honey can stop haemorrahage. You can also treat ureter stone by heating 60 grams of fresh oxalis herbs and 60 ml of arak manis until remains a half. Divide it into three dosages daily.

It means, I must eat “semanggi” more regularly. I will.

Can Hepatitis B Cause Liver Cancer?

It's well established that hepatitis B virus can cause liver cancer. But is it true? Some scientists report that a certain kind of hepatitis B is much more likely than others to lead to cancer and that large amounts of any type of the virus correlate with high cancer risk.

The researchers obtained blood samples from 4,841 men diagnosed with hepatitis B but not yet treated for the condition. Over the next 14 years, 154 of the patients developed liver cancer. The researchers then compared blood from these men with 316 similar men in the study who hadn't developed cancer. The comparison indicated that the men with cancer were five times as likely to have a kind of hepatitis B called genotype C.

Ming-Whei Yu, an epidemiologist, says, there are seven genotypes of hepatitis B, which are forms of the virus whose DNA differ from each other. The blood samples revealed that high amounts of any hepatitis genotype increase the risk of liver cancer. In particular, men whose blood carried a high load of genotype C of hepatitis B virus faced a 27-fold higher risk of developing cancer, compared with men with a low load of one of the virus' other genotypes.

Screening hepatitis B patients for their virus genotype could reveal people at especially high risk of cancer. Some medications can suppress the virus. So, I have to see my doctor now to know what kind of hepatitis B is mine….

Living With Hepatitis B

If you are a HBV (hepatitis B virus) carrier, it's your responsibility to take important steps to care for yourself and prevent the spread of HBV. Here's what to do:

KEEP OTHERS HEALTHY
Hepatitis B is transmitted by contact with infected blood, serum, semen, and vaginal fluids. Wash your hands with soap after touching your own blood or body fluids. Throw personal items such as tissues, menstrual pads, tampons, or bandages away in a plastic bag.

All cuts and open sores should be covered with a bandage. Wipe up your blood spills, then, re-clean the area with a solution of one part household bleach to ten parts water.

Tell sexual partners you have hepatitis B. Partners should be tested for HBV, and if not immune to the virus, they should receive the vaccination series of three shots. Until protection from HBV has been guaranteed, use a condom.

People living in the same household as a carrier should see their doctor for hepatitis B testing and vaccination. If anyone is exposed to the your blood or body fluids, hepatitis B immune globulin given within two days to two weeks can prevent the infection.

KEEP YOURSELF HEALTHY
Monitor the state of your liver at least once a year to determine if the disease is progressing and if cirrhosis or liver cancer is developing.

Review all medications with your physician. Even some over-the-counter and alternative medicines can harm the liver.

Have periodic ultrasound and alpha-fetoprotein blood tests for liver cancer.

If pregnant, be sure to tell your physician you are an HBV carrier so your baby will receive live-saving treatments.

On routine visits, remind your doctor, dentist, and other healthcare providers that you are an HBV carrier.

THINGS NOT TO DO
Avoid, or severely restrict, alcohol intake. Your liver may be further damaged by alcohol. If you do drink alcohol, NEVER do so with acetaminophen, found in Tylenol or other cold and headache remedies. Do not share with anyone toothbrushes, razors, needles, syringes, nail files, clippers, scissors, or any object that may come into contact with your blood or body fluids.

Do not share food that has been in your mouth and do not pre-chew food for babies.

Do not donate blood, plasma, body organs, tissue, or sperm.

KEEP LEARNING
Stay informed about research developments regarding treatments so you are able to make the best decisions. Research is now being planned and conducted to improve the treatment of chronic hepatitis C (HCV) and hepatitis B (HBV) infections by immunotherapy, and development of a vaccine for HCV.

Great places to start:
http://www.hepfi.org/
Center for Disease Control Viral Hepatitis Center:
http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm
Travel tips: http://www.cdc.gov/travel/diseases.htm#hepa

Curcuma Xanthorrhiza

The most popular Indonesian herbal for hepatitis remedy is Curcuma xanthorrhiza (i.e. Java Turmeric, in Indonesia wellknown as Temulawak). It is used by generations to increase children’s appetite, one’s body weight, to smooth breast feeding, to treat gastritis and any other digestive system, gallstone, and, of course, to treat liver diseases. Also it is believed to slow aging, anti wrinkle, and to make body more flexible.

The part used of Curcuma xanthorrhiza is the rhizome which contains 100 compounds such as amylase, fenolase, fat, kurkuminoid, and essential oils. These compounds work generally to increase body metabolism. Ollium xanthorriza has an anti-fungal, anti-bacterial and anti-inflammation properties.

Fortunately we can get all the benefit by drinking an aromatic beverage made from Curcuma xanthorrhiza. You can make it from 50 grams of fresh rhizome cut into slices, boiled in 1,500 ml of water. Add a piece of tamarind (or its leaf sprout) and 4-5 spoonfuls of sugar. Use small fire and let it boil for 30 minutes until the water remains 1000 ml.

I used to make the beverage myself, and my family like it so much.

For more practical use, you can dry the slices by the wind (don’t dry it by sun for it can damage the compounds), keep it, and use it any time in months.

Now we can also get it in capsules, liquid extract, and instant beverage. But you have to remember, never consume raw Curcuma xanthorrhiza.